CONTROLLING YOUR CONTROLLING YOUR RISK FACTORSRISK FACTORS

Taking the Steps to a Taking the Steps to a

Healthy Heart Healthy Heart

The Uncontrollable The Uncontrollable Risk FactorsRisk Factors

Increasing AgeIncreasing Age Male GenderMale Gender Family HistoryFamily History

What Are Your Controllable What Are Your Controllable Risk Factors For Heart Risk Factors For Heart Disease?Disease? SmokingSmoking Abnormal CholesterolAbnormal Cholesterol High Blood PressureHigh Blood Pressure DiabetesDiabetes Sedentary Lifestyle (Inactivity)Sedentary Lifestyle (Inactivity) Unhealthy Body WeightUnhealthy Body Weight Unmanaged StressUnmanaged Stress

Tobacco UseTobacco Use

Smoking is the #1 preventable cause of Smoking is the #1 preventable cause of premature death in USpremature death in USRisk of CAD is 2-4 times higher than Risk of CAD is 2-4 times higher than nonsmokersnonsmokersTypes of tobaccoTypes of tobaccoSecondhand smokeSecondhand smokeTake Action! Call 1-800-Quit-NowTake Action! Call 1-800-Quit-Now

Quit for GoodQuit for Good

S - Set a quit dateS - Set a quit date T - Tell peopleT - Tell people A - Anticipate challengesA - Anticipate challenges R - Remove tobaccoR - Remove tobacco T - Talk to your doctorT - Talk to your doctor

CHOLESTEROL CHOLESTEROL

Heredity and lifestyleHeredity and lifestyle Fatty deposits collect in Fatty deposits collect in

arteriesarteries Reduced blood flow Reduced blood flow Increased risk of heart Increased risk of heart

attack, stroke, aortic attack, stroke, aortic aneurysm, & PAD.aneurysm, & PAD.

What are ideal What are ideal cholesterol (lipid) cholesterol (lipid) values?values?

LDL Cholesterol “bad” < 70 LDL Cholesterol “bad” < 70 mg/dLmg/dL

HDL Cholesterol “good” HDL Cholesterol “good” – 40 mg/ dL or higher for men40 mg/ dL or higher for men– 50 mg/dL or higher for women50 mg/dL or higher for women

Triglycerides < 150 mg/dLTriglycerides < 150 mg/dL

How can you control How can you control your cholesterol?your cholesterol?

Follow a heart healthy eating planFollow a heart healthy eating plan Eat more fiberEat more fiber Take your medications as Take your medications as

prescribedprescribed Exercise regularlyExercise regularly Maintain an ideal body weightMaintain an ideal body weight Control blood sugarsControl blood sugars

OBESITYOBESITY

127 Million adults are overweight, 60 M obese, 127 Million adults are overweight, 60 M obese, 9 M severely obese 9 M severely obese 1.1.

Obesity accounts for 280,000-350,000 deaths Obesity accounts for 280,000-350,000 deaths per yearper year

22ndnd leading cause for preventable deaths in U.S. leading cause for preventable deaths in U.S. Waist Measurement and the Body Mass Index Waist Measurement and the Body Mass Index

are the recommended ways to estimate body are the recommended ways to estimate body fat.fat.Body Mass Index (BMI) > 25 kg/mBody Mass Index (BMI) > 25 kg/m22

Waist Circumference > 40” (102 cm) in men Waist Circumference > 40” (102 cm) in men Waist Circumference > 35” (89 cm) in womenWaist Circumference > 35” (89 cm) in women

Booth, F.W., et al., J Appl. Physiol. 88:774-787,2000.

Body Mass Index (BMI)Body Mass Index (BMI)

BMI 18 to 24.9 is NormalBMI 18 to 24.9 is Normal BMI 25.0-29.9 is OverweightBMI 25.0-29.9 is Overweight BMI >30 is ObeseBMI >30 is Obese BMI >40 is Extremely ObeseBMI >40 is Extremely Obese To Calculate…Multiply your weight by 703, To Calculate…Multiply your weight by 703,

divide by your height in inches, then divide divide by your height in inches, then divide again by your height in inchesagain by your height in inches

Body Mass Body Mass Calculator-americanheart.org/bodymass.Calculator-americanheart.org/bodymass.

How Can You Help to How Can You Help to Control Your Weight?Control Your Weight?

Follow a heart healthy Follow a heart healthy diet low in saturated fatdiet low in saturated fat

Watch portion sizesWatch portion sizes Do not skip mealsDo not skip meals Make sure you are Make sure you are

getting enough fibergetting enough fiber Drink plenty of waterDrink plenty of water Exercise dailyExercise daily Set realistic goals – Set realistic goals –

weight loss should be weight loss should be gradual (1-2 pounds per gradual (1-2 pounds per week)week)

EFFECTS OF OBESITY EFFECTS OF OBESITY ON HEART DISEASE ON HEART DISEASE RISKRISK Raises blood cholesterol and Raises blood cholesterol and

triglyceride levelstriglyceride levels Lowers HDL “good” cholesterolLowers HDL “good” cholesterol Raises blood pressure levelsRaises blood pressure levels Increases your risk of developing Increases your risk of developing

diabetesdiabetes

HYPERTENSION=Silent HYPERTENSION=Silent KillerKiller

Blood pressure ≥ 120/80 mm Hg on at least 2 separate occasions OR on antihypertensive medication.

When left uncontrolled, it can damage blood vessels leading to problems such as heart and vascular disease, stroke and

peripheral arterial disease.

What can you do to What can you do to lower your blood lower your blood pressure?pressure? Eat healthier: Limit the amount of Eat healthier: Limit the amount of

fat and salt in your dietfat and salt in your diet Lose weight if you need toLose weight if you need to Begin a regular exercise programBegin a regular exercise program Learn to manage stressLearn to manage stress If you smoke, QUITIf you smoke, QUIT Drink alcohol in moderationDrink alcohol in moderation

Diabetes Diabetes

20.8 million people have Diabetes, 6.2 20.8 million people have Diabetes, 6.2 million people are undiagnosed.million people are undiagnosed.1.1.

Diabetes is equivalent to having the Diabetes is equivalent to having the diagnosis of Heart Disease.diagnosis of Heart Disease.

Insulin resistance is a characteristic of Type 2 Insulin resistance is a characteristic of Type 2 Diabetes. Diabetes cause many metabolic Diabetes. Diabetes cause many metabolic abnormalities causing vascular changes abnormalities causing vascular changes leading to heart disease. leading to heart disease.

Diagnostic Criteria -Diagnostic Criteria -– Fasting blood sugars >126 mg/dL X 2 testsFasting blood sugars >126 mg/dL X 2 tests

““Pre-Diabetes”Pre-Diabetes”

Also called impaired Also called impaired fasting glucose.fasting glucose.

A person with “pre-A person with “pre-diabetes” will have a diabetes” will have a fasting blood sugar of fasting blood sugar of 100-125 mg/dL.100-125 mg/dL.

Increases a person’s risk Increases a person’s risk for developing Type 2 for developing Type 2 Diabetes, heart disease Diabetes, heart disease and stroke.and stroke.

A 5-10% reduction in A 5-10% reduction in body weight will body weight will produce a 58% produce a 58% reduction in developing reduction in developing Diabetes.Diabetes.

What can you do to lower What can you do to lower blood sugars?blood sugars?

Exercise dailyExercise daily Take your medications as Take your medications as

directeddirected Eat a diet rich in fiber and low in Eat a diet rich in fiber and low in

refined carbohydratesrefined carbohydrates Weight loss Weight loss

Physical InactivityPhysical Inactivity

¼ of all adults have ¼ of all adults have completely sedentary completely sedentary lifestyles.lifestyles.

More than 60% of all More than 60% of all adults are not adults are not regularly physically regularly physically active and 60% are active and 60% are overweight.overweight.

The Surgeon General’s The Surgeon General’s Report recommends Report recommends we are to accumulate we are to accumulate 30 minutes or more of 30 minutes or more of physical activity on physical activity on most days of the most days of the week.week.

Benefits of Exercise-Benefits of Exercise-

ExerciseExercise…… is the …… is the only only treatment that improves treatment that improves allall risk factors for Heart risk factors for Heart Disease!!!!!Disease!!!!!

Numbers that Count for a Numbers that Count for a Healthy HeartHealthy Heart

Ideal Blood Pressure Ideal Blood Pressure <120/80 mm Hg<120/80 mm Hg

Fasting Blood Fasting Blood Sugars<100Sugars<100

Body Mass Index<25Body Mass Index<25Waist CircumferenceWaist Circumference

Women < 35” Women < 35” Men < 40”Men < 40”

Physical Activity-30 Physical Activity-30 minutes of moderate minutes of moderate intensity intensity allall days of days of the week.the week.

Strength Training at Strength Training at least least

2 days per week2 days per week

CholesterolCholesterol– LDL cholesterol<70 LDL cholesterol<70 – HDL cholesterol >50 HDL cholesterol >50

for womenfor women HDL cholesterol >40 HDL cholesterol >40

for menfor men -Triglycerides<150-Triglycerides<150

Other Contributing Other Contributing Factors….Factors…. Stress/Anxiety/DepressionStress/Anxiety/Depression-Will -Will

increase heart rate and blood pressure.increase heart rate and blood pressure. AlcoholAlcohol--Increases Triglyceride, body Increases Triglyceride, body

weight and blood pressure. Excessive weight and blood pressure. Excessive alcohol can cause enlargement of the alcohol can cause enlargement of the heart.heart.

– Women: NO more than 1 drink per Women: NO more than 1 drink per dayday

– Men: NO more than 2 drinks per dayMen: NO more than 2 drinks per day 1 drink= 5 oz. wine, 1 oz. liquor or 12 1 drink= 5 oz. wine, 1 oz. liquor or 12

oz. beer oz. beer

FINAL THOUGHTS…FINAL THOUGHTS…

““Our understanding of Heart Disease has Our understanding of Heart Disease has expanded enormously over the past 30 expanded enormously over the past 30 years. We know that combining necessary years. We know that combining necessary medications with important lifestyle medications with important lifestyle choices dramatically decreases future risk choices dramatically decreases future risk of a heart attack. You have the power to of a heart attack. You have the power to make these choices every day of your life make these choices every day of your life and to teach the next generation the and to teach the next generation the importance of heart-healthy living !!” importance of heart-healthy living !!”

Dr. Pearson, Dean/St. Mary’s Preventive CardiologyDr. Pearson, Dean/St. Mary’s Preventive Cardiology